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Valvular Heart Disease: Aortic Stenosis

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Acquired valvular heart diseases may manifest as insufficiencies (i.e., the incomplete closure of the valve), as a stenosis (i.e., a narrowing of the valve), or as a combined valvular defect. In principle, all valves can be affected. The aortic valve stenosis and the mitral regurgitation are particularly frequent.

Valvular heart diseases. Where are we and what are we doing? My goodness. There is so much to discuss here, but approaches one valve at a time. And as we do so, we will dissect every single aspect of that valvular heart disease so that by the time you have gone through this, you know who your patient is, what they are presenting with and understand the pathogenesis of what guide is here in the first place. Let us begin. Here once again is the chest. How important is this chest? Quite. We talked about the aortic area. I want you to point to it. Where am I? Right parasternal second intercostal space. Why? Because in anatomy of your aorta, take a look at the arch and so therefore, that is where you normally would hear your aortic valve. If you are dealing with a systolic murmur, take a look at aortic stenosis and I told you about that patient thus feeling tired, fatigue, maybe a little bit of chest pain with exertion. Let us talk about that for one second here. If it is aortic stenosis, what is causing this chest pain? It is not myocardial infarction, but it is the fact that with aortic stenosis, the left ventricle is having a hard time kicking against that increased afterload and so therefore the left ventricle is lifting weights. Once upon a time, when I was younger and I was lifting weights, I was undergoing hypertorphy of my biceps. Nowadays it is more about atrophy. But as far as the left ventricle is concerned, it is also lifting weights. What are the weights in this environment? The stenotic aortic valve. So what is the hypertrophy that we were referring to in the left ventricle? It is the fact that it...